Therapy-related myeloid leukemia.

Abstract

Therapy-related myelodysplastic syndrome and acute myeloid leukemia (t-MDS/t-AML) are thought to be the direct consequence of mutational events induced by chemotherapy, radiation therapy, immunosuppressive therapy, or a combination of these modalities, given for a pre-existing condition. The outcomes for these patients have been poor historically compared to people who develop de novo AML. The spectrum of cytogenetic abnormalities in t-AML is similar to de novo AML, but the frequency of unfavorable cytogenetics, such as a complex karyotype or deletion or loss of chromosomes 5 and/or 7, is considerably higher in t-AML. Survival varies according to cytogenetic risk group in t-AML patients, with better outcomes being observed in those with favorable-risk karyotypes. Treatment recommendations should be based on performance status and karyotype. A deeper understanding of the factors that predispose patients to the development of therapy-related myeloid leukemia would help clinicians monitor patients more carefully after treatment for a primary condition. Ultimately, this knowledge could influence initial treatment strategies with the goal of decreasing the incidence of this serious complication.

• Authors: Lucy A Godley, Richard A Larson
• Journal: Seminars in oncology (Semin Oncol) Vol. 35 Issue 4 Pg. 418-29 (Aug 2008) ISSN: 0093-7754 [Print] United States
• PMID: 18692692 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Review)

Chemical References

• Antineoplastic Agents

Topics

• Antineoplastic Agents (adverse effects)
• Chromosome Aberrations
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Leukemia, Myeloid, Acute (etiology)
• Mutation
• Neoplasms, Second Primary (genetics, therapy)
• Radiotherapy (adverse effects)
• Risk Factors
• Translocation, Genetic
• Treatment Outcome